Kisplyx (Lenvatinib)

Lenvatinib is used in oncology to inhibit angiogenesis and tumor growth in several solid tumours.

• Differentiated thyroid cancer: improves progression‑free survival in patients with radioactive‑iodine refractory disease.
• Renal cell carcinoma: reduces tumor burden and extends overall survival in advanced clear‑cell disease.
• Hepatocellular carcinoma: delays disease progression in patients with unresectable or metastatic liver cancer.

• Lenvatinib blocks the activity of multiple receptor tyrosine kinases, including VEGFR1‑3, FGFR1‑4, PDGFRα, RET and KIT. By inhibiting these pathways, it suppresses tumor angiogenesis, proliferation and survival signals, leading to reduced blood vessel formation and direct anti‑tumor effects in responsive cancers. The inhibition of VEGFR disrupts endothelial cell signaling, while FGFR blockade interferes with fibroblast growth factor–driven tumor cell proliferation. PDGFRα suppression reduces stromal support, and RET/KIT inhibition further impairs oncogenic signaling cascades, collectively producing anti‑angiogenic and anti‑proliferative activity.

Lenvatinib is associated with a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Hypertension: elevated blood pressure often requiring medication.
• Diarrhea: mild to moderate gastrointestinal upset.
• Fatigue: persistent tiredness affecting daily activities.
• Nausea: occasional feeling of sickness.

Serious or Rare Side Effects

• Hepatotoxicity: severe liver enzyme elevations or liver failure.
• Cardiac dysfunction: heart failure or reduced ejection fraction.
• Gastrointestinal perforation: rare but life‑threatening ulceration.

Before initiating Kisplyx, several safety considerations should be observed.

• Blood pressure monitoring: check regularly and manage hypertension promptly.
• Liver function tests: assess baseline and periodic hepatic enzymes.
• Cardiac evaluation: perform echocardiogram before treatment and monitor for signs of heart failure.
• Renal function: monitor serum creatinine and urine protein.
• Pregnancy and lactation: avoid use during pregnancy and breastfeeding unless benefits outweigh risks.
• Store at ambient temperature: keep below 25 °C, protect from moisture and light in original packaging.

Lenvatinib may interact with other medicines; some combinations should be avoided while others require close observation.

Major Interactions (Avoid)

• Strong CYP3A4 inducers: may reduce lenvatinib exposure (e.g., rifampin, carbamazepine).
• Anticoagulants: increased risk of bleeding when combined with warfarin or direct oral anticoagulants.
• Antihypertensive agents: concurrent use may exacerbate blood pressure changes.

Moderate Interactions (Monitor Closely)

• CYP3A4 inhibitors: can increase plasma levels (e.g., ketoconazole, clarithromycin).
• Gastric pH modifiers: antacids may affect absorption.
• Diuretics: may potentiate hypertension or electrolyte disturbances.